Individual provider Active NPI

Ibrahim Barhim Haddad, PA-S

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1396586707
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5850 E Still Cir
Mesa, AZ 85206-3618
Phone
(480) 219-6000
NPI assigned
Jun 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X AZ
Physician Assistant 363A00000X AZ Primary
Medical Physician Assistant 363AM0700X AZ

Addresses

Primary practice location

5850 E Still Cir
Mesa, AZ 85206-3618

Mailing address

5850 E Still Cir
Mesa, AZ 85206-3618
Phone (480) 219-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251122000999 AZ Practitioner - Physician Assistant 1658863105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

5310 W Thunderbird Rd
Suite 308
Glendale, AZ 85306-4710
Phone (602) 865-4442

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Nov 11, 2025 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Nov 11, 2025 Accepting new patients
Banner - University Physician Specialists LLC Current Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 308
Glendale, AZ 85306
Phone (602) 865-4442

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1396586707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "480-219-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "480-219-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "IBRAHIM",
        "middle_name": "BARHIM",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.